细胞因子对异种脱细胞真皮基质免疫调节作用的临床研究  

Clinical study on the immunoregulation effects of cytokines on the acellular xenogenic dermal matrix

作　　者：姜笃银[1] 陈璧第 

机构地区：[1]第四军医大学西京医院烧伤科

出　　处：《中华烧伤杂志》2003年第6期351-354,共4页Chinese Journal of Burns

基　　金：国家自然科学基金资助项目 ( 3 90 70 82 2 )

摘　　要：目的　探讨烧伤患者接受异种 /异体脱细胞真皮基质 (xeno /allo ADM )移植后全身和局部多种细胞因子与移植物近期转归的关系。　方法　在大面积烧伤患者的四肢切痂创面上 ,移植xeno ADM (12例 ,19块 )或allo ADM(15例 ,18块 ) ,其上覆盖自体超薄断层皮片 ,并以 6例单纯移植自体中厚断层皮片 (auto TTS)的烧伤患者为对照。移植物成活后 4～ 8周 ,收集局部组织标本、血清和xeno ADM排斥后的创面渗出液 ,采用免疫组织化学染色与酶联免疫吸附法 (ELISA) ,检测白细胞介素 (IL) 1β、IL 4、IL 6、肿瘤坏死因子α(TNF α)和γ型干扰素 (IFN γ)的含量。　结果　免疫组织化学染色结果显示 ,移植物内IL 1β、IL 4、IL 6、TNF α和IFN γ的阳性细胞密度或着色强度相比较 ,xeno ADM >allo ADM >auto TTS (P <0 .0 5 )。ELISA检测结果显示 ,xeno ADM被排斥后创面渗出液中IL 4、IL 6、TNF α和IFN γ水平明显高于自体血清 ,但其血清IL 4与IFN γ水平分别低于和高于未排斥时。xeno ADM移植后血清中IL 4、IFN γ水平明显高于allo ADM和auto TTS(P <0 .0 5～ 0 .0 1)。　结论　xeno ADM移植后可在局部检测到高水平的IL 1β、IL 4、IL 6、IFN γ ,可能与细胞杀伤和细胞因子介导的免疫放大作用有关。Objective To investigate the relationship between some cytokines and early outcome of grafts in burn patients receiving xeno-/allo-ADM grafting. Methods Nineteen xeno-ADMs were grafted onto the wounds of 12 patients after escharectomy in extremities, and 18 allo-ADMs were grafted onto the escharectomy wounds of 15 patients in extremities. All the grafts were covered with thin split thickness skin autografts . Six patients grafted with split thickness skin autografts(auto-TTS) were employed as control. After the grafts survived for 4 to 8 weeks, immunohistochemistry and ELISA methods were employed to determine the contents of IL-1β,IL-4, IL-6, TNF-α and IFN-γ in the exudation fluid from wounds after the rejection of xeno-ADM, local skin and peripheral blood. Results It was exhibited by immunochemistry staining that the positive cellular density and staining intensity of the IL-1β,IL-4, IL-6, TNF-α and IFN-γ in the grafts were ranked as following: Xeno-ADM >allo-ADM>auto-TTS(P<0.05-0.01). The levels of IL-4, IL-6, TNF-α and IFN-γ in the exudation fluid during the rejection of xeno-ADM were obviously higher than those in the blood of the patients as determined by ELISA, while the serum levels of IL-4 and IFN-γ in xeno-ADM group were lower and higher than those in xeno-ADM when without rejection respectively. The serum levels of IL-4, TNF-α and IFN-γ in xeno-ADM group were significantly higher than those in allo-ADM and auto-TTS groups(P<0.05-0.01). Conclusion Local detection of high levels of IL-1β,IL-4, IL-6, TNF-α and IFN-γ might be related to the immune augmentation mediated by cytotoxic lymphocytes and cytokines.The dynamic changes of these cytokines might be helpful to the exlaination of the bad outcome of xeno-ADMs. [

关 键 词：细胞因子 异种脱细胞真皮基质 免疫调节 免疫组织化学 酶联免疫吸附法 细胞外基质 

分 类 号：R644[医药卫生—外科学]